Healthcare Provider Details

I. General information

NPI: 1932267697
Provider Name (Legal Business Name): SEKITO CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 MORENA BLVD
SAN DIEGO CA
92110-3725
US

IV. Provider business mailing address

1465 MORENA BLVD
SAN DIEGO CA
92110-3725
US

V. Phone/Fax

Practice location:
  • Phone: 619-275-6565
  • Fax: 619-275-0300
Mailing address:
  • Phone: 619-275-6565
  • Fax: 619-275-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC3996
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC15034
License Number StateCA

VIII. Authorized Official

Name: DR. JUNKO SEKITO
Title or Position: PRESIDENT
Credential: D.C., L.AC.
Phone: 619-275-6565